Foreign Body Removal
“I know there’s a wire right here in my arm. I saw it go in but I couldn’t stop it and I couldn’t get a hold of it, but I know it’s in there”
And he was right. There was an inch long small gauge wire in his left forearm. Although it was difficult to feel, I could feel something that felt like a wire so I knew I could probably get it. I injected a small amount of local anesthesia and made a small incision right over that area. Sure enough, there it was. It was removed and given to the patient in a small container.
“Foreign bodies can be anything that doesn’t belong… from splinters to fishhooks to bullets to glass pieces to well… wires. The general rule for the surgeon is, if you can feel it, you can go after it. If a patient says “there’s something there” but you can’t feel it, it’s a hunting expedition and they are seldom rewarding.
If the foreign body is in a finger, a splinter, for example, a finger block is done (with plain lidocaine) so that the entire finger is made numb. That allows the surgeon to dissect out the splinter without having the surrounding tissue distorted by the lidocaine.
“What’s the weirdest/wildest thing you have ever retrieved, doc?” I removed a 44 magnum bullet form a man’s shoulder that had, over several years, worked it’s way to the surface so it was easily felt just under the skin. It was no trouble getting it out. (If you’re a fan of old westerns, I felt like I needed a metal pan to throw it in just to hear it clank!)